Multiple Sclerosis (MS) is an inflammatory disease of the nervous system in which the immune systems attacks the protective coating of the nerves, as well as the nerves themselves. This disrupts communication between the brain and spinal cord, causing a variety of symptoms, of also varying severity. It can be disabling, but isn’t always, as it has several forms. MS may progress, or may calm down and flare up periodically. Many people with MS remain able to walk, but many use aids such as canes, crutches or scooters to help. It’s hard to say how prevalent MS is because it isn’t tracked, but is more common in women than men.
CAUSES AND RISK FACTORS
Causes and risk factors for developing MS are fairly unknown. We know that an abnormal immune response causes the body to attack the nerves, and even what types of cells are involved, but not exactly what starts the process. Scientists are exploring infectious factors (viruses), genetics, and environmental factors that all may play into how MS begins.
MS is more common in women, and more common in Caucasians, though it does affect other ethnic groups. And while a direct genetic link hasn’t been determined, the risk of developing MS is higher if you have a direct family member who has it.
Symptoms vary and are unpredictable, and may fluctuate over time.
More common symptoms include
- Fatigue/ Sleep disturbances
- Difficulty walking
- Numbness or tingling (could also be itching, but that is less common)
- Muscle spasticity (more common in the legs)
- Vision problems
- Bladder and Bowel problems
- Cognitive changes
- Emotional changes including Depression (very common in MS)
Other symptoms related to muscle weakness and/or spasm may be present, especially later in the course of disease. Examples: problems with speech, swallowing, breathing, tremors, seizures.
DIAGNOSIS AND TESTS
Diagnosing MS is very difficult because practically all of the symptoms overlap with other conditions. No symptoms, physical findings or laboratory tests can, by themselves, determine if a person has MS. MS is diagnosed when there is damage in at least 2 areas of the central nervous system, that occurred at least a month apart, and other diagnoses are ruled out. Testing will include a careful medical history, neurologic exams and various tests including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis.
MS is a complex disease requiring complex care, and at this time cannot be cured. Frequently, treatment involves a team of professionals including a neurologist, rehabilitation and therapy professionals, pharmacists, mental health professionals, and others. Relapsing forms of MS can be treated with medications that reduce exacerbations and slow the progress of the disease. There are 13 currently on the market. Some are given orally, but some must be given by injection or infusion. Monitoring for side effects, some of them serious, is important and our team is here to help.
- glatiramer acetate (Copaxone; 1996)
- glatiramer acetate (Glatopa; 2015 — generic equivalent of Copaxone)
- interferon b-1a (Avonex; 1996)
- interferon b-1a (Rebif; 1998)
- interferon b-1b (Betaseron; 1993)
- interferon b-1b (Extavia; 2009)
- pegylated interferon b-1a (Plegridy; 2014)
- dimethyl fumarate (Tecfidera, 2013)
- fingolimod (Gilenya; 2010)
- teriflunomide (Aubagio; 2012)
- alemtuzumab (Lemtrada: 2014)
- mitoxantrone (Novantrone; 2000)
- natalizumab (Tysabri; 2006)
Without treatment, about 30% of patients with MS will develop significant physical disability within 20-25 years after onset. Medications to slow the progress of MS show promising results in short term studies, but long term effectiveness is unknown. Even patients with milder forms of MS and fewer physical symptoms tend to show some cognitive decline over the decades following diagnosis. Males with primary progressive MS have the worst prognosis, as they seem to be less responsive to treatment and have a higher degree and incidence of disability.
Life expectancy is shortened only slightly in persons with MS. 50-60% of MS patient deaths are due to secondary complications, such as pulmonary or renal causes, but can also be due to primary complications, suicide, and causes unrelated to MS.
LINKS and SUPPORT
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- 17 Jun 2015
- FOSRX/FAST Services